Invitation to discuss the master's thesis of Dr. Aya Saber Khalifa Mohamed, Teaching Assistant, Department of Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University
Background
Juvenile idiopathic arthritis (JIA) is an autoimmune, inflammatory noninfective joint disease that includes different disease subtypes that are characterized by the onset of arthritis starting before the age of 16 years with symptoms lasting at least for 6 weeks.
Objective
The aim of this study was to evaluate the compliance of healthcare providers at the Pediatric Rheumatology Unit, Assiut University Children’s Hospital, to the 2011 American College of Rheumatology recommendations for treatment of JIA.
Patients and methods
The study was conducted on 50 patients who were younger than 16 years and diagnosed as having JIA at the Pediatric Rheumatology Unit, Assiut University Children’s Hospital, to assess compliance of the unit’s healthcare providers to American College of Rheumatology recommendations for treatment of JIA.
Results
The patients were grouped according to age into two groups: from 1 to 7 and 8 to 16 years. Polyarticular JIA was the most common type among studied cases followed by systemic‑onset JIA. All studied cases presented with arthritis at the time of diagnosis. Complete blood count and erythrocyte sedimentation rate were done for all studied cases at the time of diagnosis. Rheumatoid factor was done for 84%. The most common complications among the studied group were those related to treatment. NSAIDs and corticosteroids were the most common drugs used.
Conclusion
Treatment of JIA includes pharmacological and nonpharmacological interventions and surgical treatment. Pharmacological treatment includes NSAIDs, steroids, disease‑modifying antirheumatic drugs, and biological agents. The degree of disease activity and the presence or absence of features of poor prognosis greatly affect onset of complications and treatment of JIA. Nonpharmacological interventions include psychosocial therapy, nutrition, physical and occupational therapy, lifestyle factors, and home remedies. Through this study, some defects were found. First, there was deficiency in data recording. Second, there was also deficiency in laboratory (mainly rheumatoid factor and antinuclear antibody/anti‑double stranded DNA) and radiological workup. Moreover, nonpharmacological therapy and surgery were not considered. Lastly, there was deficiency in regular follow‑up of safety drug monitoring.
Background: The shortage of healthcare professionals, coupled with the expansion of health services, has made Community Health Workers (CHWs) an effective solution to bridge these gaps. The objective was to determine the actual employed services of CHWs in the health system with especial emphasis on their role in family planning services. Methods: A cross-sectional study was conducted among 250 CHWs from Assiut governorate using a self-administered questionnaire about sociodemographic and job characteristics together with roles and tasks performed by CHWs. Results: All CHWs in the study were female, with 51.2% being under 40 years old and 82% were recruited by the Ministry of Health and Population. CHWs primarily served mothers and children (99.2%) and were involved in health education (100%), puerperium care (99.2%), family planning (98.8%), pregnancy (97.6%) and breastfeeding (96%). They also participated in health initiatives like family planning (98.8%) and maternal and childcare (92.4%). The most common health issue observed by CHWs was chronic diseases (73.2%), while non-medical concerns included poverty (78.4%) and unemployment (78.4%). Conclusion and recommendation: CHWs offer a wide range of health services, provide health education, and actively participate in various health initiatives. The study emphasized the crucial role of CHWs in strengthening health systems, particularly in rural areas, by enhancing both coverage and quality of services. It is essential for health system stakeholders to focus on developing a training program matching a clear job description to ensure that CHWs can maximize their impact in meeting community health needs.